Name: Harris Veterinary Medical Center
Address: 730 Northwest 43rd St, Gainesville, FL, 32605, US
Telephone: 352 554 4115
Price range: $$

New Client Registration Form

Thank you for considering our hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together.

Please complete this form as fully as possible prior to your first appointment which will help expedite the registration process and give us valuable insight in providing optimal care for your pet(s). The required sections have a red * asterisk.

Owner's Name
Name*
First Last
Mobile Phone
Email*
Enter Email Confirm Email
Pet Information
Pet's Name*
Species*
Breed (if known)
Date of Birth or Age (if known)
Sex
Previous Veterinary Practice (if any)
Date of last vaccines (if known)
Date Format: MM slash DD slash YYYY
What vaccines were given at this time
Is your pet on any medication or supplement?
- Yes
- No
If Yes, please list the medication or supplement
Does your pet have allergies or drug reactions?
- Yes
- No
If Yes, please list the allergies and reactions
Please use the following box to give us any other relevant information about your pet

Request an Appointment Today!

Where to Find Us

730 Northwest 43rd St,
Gainesville, FL, 32605

352 554 4115
info@harrisvmc.com

Get Directions

Mon: 8am – 6pm
Tue: 8am – 6pm
Wed: 8am – 6pm
Thur: 8am – 6pm
Fri: 8am – 6pm
Sat: 8am – 2pm
Sun: closed

New Client Registration Form

Owner's Name

Pet Information

Request an Appointment Today!

Where to Find Us